NCHS Data Brief ■ No. 121 ■ May 2013

U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Disease Control and Prevention

National Center for Health Statistics

Trends in Allergic Conditions Among Children:

United States, 1997–2011

Kristen D. Jackson, M.P.H.; LaJeana D. Howie, M.P.H., C.H.E.S.; Lara J. Akinbami, M.D.

Key findings

Data from the National 

Health Interview Survey, 

1997–2011

•	 The prevalence of food 

and skin allergies increased in 

children under age 18 years 

from 1997–2011.

•	 The prevalence of skin 

allergies decreased with age. 

In contrast, the prevalence of 

respiratory allergies increased 

with age.

•	 Hispanic children had a 

lower prevalence of food 

allergy, skin allergy, and 

respiratory allergy compared 

with children of other race or 

ethnicities. Non-Hispanic black 

children were more likely to 

have skin allergies and less 

likely to have respiratory 

allergies compared with nonHispanic white children.

•	 Food and respiratory 

allergy prevalence increased 

with income level. Children 

with family income equal to 

or greater than 200% of the 

poverty level had the highest 

prevalence rates.

Allergic conditions are among the most common medical conditions affecting 

children in the United States (1–5). An allergic condition is a hypersensitivity 

disorder in which the immune system reacts to substances in the environment 

that are normally considered harmless (6,7). Food or digestive allergies, skin 

allergies (such as eczema), and respiratory allergies (such as hay fever) are the 

most common allergies among children. Allergies can affect a child’s physical 

and emotional health and can interfere with daily activities, such as sleep, 

play, and attending school (8,9). A severe allergic reaction with rapid onset, 

anaphylaxis, can be life threatening. Foods represent the most common cause 

of anaphylaxis among children and adolescents (10,11). Early detection and 

appropriate interventions can help to decrease the negative impact of allergies 

on quality of life (6). This report presents recent trends in the prevalence of 

allergies and differences by selected sociodemographic characteristics for 

children under age 18 years.

Keywords: allergy • National Health Interview Survey

The prevalence of food and skin allergies increased in 

children aged 0–17 years from 1997–2011.

Figure 1. Percentage of children aged 0–17 years with a reported allergic condition in the past 

12 months: United States, 1997–2011 

1

Significant increasing linear trend for food and skin allergy from 1997–1999 to 2009–2011.

SOURCE: CDC/NCHS, Health Data Interactive, National Health Interview Survey. Percent

3-year period

0

5

10

15

20

1997–1999 2000–2002 2003–2005 2006–2008 2009–2011

Respiratory allergy

Skin allergy1

Food allergy1
NCHS Data Brief ■ No. 121 ■ May 2013

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Among children aged 0–17 years, the prevalence of food allergies increased from 3.4% in 1997–

1999 to 5.1% in 2009–2011. The prevalence of skin allergies increased from 7.4% in 1997–1999 

to 12.5% in 2009–2011. There was no significant trend in respiratory allergies from 1997–1999

to 2009–2011, yet respiratory allergy remained the most common type of allergy among children 

throughout this period (17.0% in 2009–2011). Skin allergy prevalence was also higher than food 

allergy prevalence for each period from 1997–2011 (Figure 1).

Younger children were more likely to have skin allergies, while older 

children were more likely to have respiratory allergies.

Food allergy prevalence was similar among all age groups. Skin allergy prevalence decreased 

with the increase of age (14.2% among 0–4 years, 13.1% among 5–9 years, and 10.9% among 

10–17 years); while respiratory allergy prevalence increased with the increase of age (10.8% 

among 0–4 years, 17.4% among 5–9 years, and 20.8% among 10–17 years) (Figure 2).

Figure 2. Percentage of children aged 0–17 years with a reported allergic condition in the past 12 months, by age group: 

United States, average annual 2009–2011

1

Significant trend by age group.

SOURCE: CDC/NCHS, Health Data Interactive, National Health Interview Survey.

Allergy type

0

5

10

15

20

25

Respiratory allergy Skin allergy1 1 Food allergy

Percent

0–4 years 5–9 years 10–17 years
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Hispanic children had lower rates of all three types of allergies compared 

with children of other race or ethnicities. Non-Hispanic black children 

were more likely to have skin allergies and less likely to have respiratory 

allergies compared with non-Hispanic white children.

Hispanic children had a lower prevalence of food allergy (3.6%), skin allergy (10.1%), and 

respiratory allergy (13.0%) compared with non-Hispanic white and non-Hispanic black children. 

Non-Hispanic black children had a higher percentage of reported skin allergy (17.4%) compared 

with non-Hispanic white children (12.0%) and a lower percentage of respiratory allergy (15.6%) 

compared with non-Hispanic white children (19.1%) (Figure 3).

Figure 3. Percentage of children aged 0–17 years with a reported allergic condition in the past 12 months, by race and 

ethnicity: United States, average annual 2009–2011 

1

Hispanic significantly different than all other race groups. 

2

The differences between all race groups are statistically significant. 

SOURCE: CDC/NCHS, Health Data Interactive, National Health Interview Survey.

Allergy type

0

5

10

15

20

25

Respiratory allergy Skin allergy2 2 Food allergy1

Percent

Non-Hispanic white Non-Hispanic black Hispanic
NCHS Data Brief ■ No. 121 ■ May 2013

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The prevalence of food and respiratory allergy, but not skin allergy, 

increased with higher income levels.

The prevalence of both food allergy and respiratory allergy increased with the increase of income 

level. Among children with family income less than 100% of the poverty level, 4.4% had a 

food allergy and 14.9% had a respiratory allergy. Food allergy prevalence among children with 

family income between 100% and 200% of the poverty level was 5.0%, and respiratory allergy 

prevalence was 15.8%. Among children with family income above 200% of the poverty level, 

food allergy prevalence was 5.4%, and respiratory allergy prevalence was 18.3%. There was no 

significant difference in the prevalence of skin allergy by poverty status (Figure 4).

Figure 4. Percentage of children aged 0–17 years with a reported allergic condition in the past 12 months, by poverty 

status: United States, average annual 2009–2011 

1

Significant trend by poverty status. 

SOURCE: CDC/NCHS, Health Data Interactive, National Health Interview Survey.

0

5

10

15

20

25

Respiratory allergy Skin allergy 1 Food allergy1

Percent

Greater than 200%

of the poverty level

100%–less than 200%

of the poverty level

Less than 100%

of the poverty level

Allergy type
NCHS Data Brief ■ No. 121 ■ May 2013

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Summary

Among children under age 18 years in the United States, the prevalence of food and skin allergies 

increased from 1997–1999 to 2009–2011. The prevalence of respiratory allergy, which is the 

most prevalent type of allergy among children, did not change during this period. There was 

no significant difference in food allergy prevalence between age groups. However, skin allergy

decreased with the increase of age, and respiratory allergy increased with the increase of age. 

The prevalence of allergies varies by race and ethnicity, with Hispanic children having the lowest 

prevalence of food, skin, and respiratory allergies compared with non-Hispanic white and nonHispanic black children. Non-Hispanic black children were more likely to have skin allergies 

and less likely to have respiratory allergies compared with non-Hispanic white children. The 

prevalence of allergies differed by poverty status. Food allergy and respiratory allergy increased 

with the increase of income level, but there was no difference in the prevalence of skin allergy by 

poverty status.

Definitions

Respiratory allergy prevalence: Estimated based on affirmative responses to either of the two

National Health Interview Survey (NHIS) question(s): “During the past 12 months, has your 

child had hay fever?” and “During the past 12 months, has your child had any kind of respiratory 

allergy?”

Food allergy prevalence: Estimated based on an affirmative response to the NHIS question:

“During the past 12 months, has your child had any kind of food or digestive allergy?”

Skin allergy prevalence: Estimated based on an affirmative response to the NHIS question:

“During the past 12 months, has your child had eczema or any kind of skin allergy?”

Poverty status: Based on family income, family size, and the number of children in the family; 

and for families with two or fewer adults, on the age of the adults in the family. The poverty 

level is based on a set of income thresholds that vary by family size and composition. Families 

or individuals with income below their appropriate thresholds are classified as below the poverty

level. These thresholds are updated annually by the U.S. Census Bureau to reflect changes in the

Consumer Price Index for all urban consumers (12). Estimates by poverty status from NHIS are 

based on both reported and imputed family income (13).
NCHS Data Brief ■ No. 121 ■ May 2013

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Data source and methods

Prevalence estimates for allergic conditions were obtained from the Health Data Interactive 

(HDI) table, “Allergic conditions, ages 0–17: U.S., 1997–2011,” available from the Health Data 

Interactive website: http://www.cdc.gov/nchs/hdi.htm. NHIS data were used to estimate the 

prevalence of allergic conditions for this HDI table.

NHIS data are collected continuously throughout the year for the Centers for Disease Control and 

Prevention’s National Center for Health Statistics by interviewers from the U.S. Census Bureau. 

NHIS collects information about the health and the health care of the civilian noninstitutionalized 

U.S. population. Interviews are conducted in respondents’ homes, but follow-ups to complete the 

interviews may be conducted over the telephone. The Sample Child component collects detailed 

data on health conditions for a randomly selected child in households with at least one child. All 

of the data in the Sample Child component are obtained from a proxy respondent and not from 

medical records. A responsible adult, usually a parent, responds to the survey questions as proxy 

for the sample child. For further information about NHIS and the questionnaire, visit the NHIS 

website at http://www.cdc.gov/nchs/nhis.htm.

NHIS is designed to yield a sample that is representative of the civilian noninstitutionalized 

population of the United States, and the survey uses weighting to produce national estimates. 

Data weighting procedures are described in more detail elsewhere (14). Point estimates and 

estimates of corresponding variances for the HDI estimates were calculated using SUDAAN 

software (15) to account for the complex sample design of NHIS. The Taylor series linearization 

method was chosen for variance estimation.

Differences between percentages were evaluated using two-sided significance tests at the 0.05

level. Terms such as “higher” and “lower” indicate statistically significant differences. Terms

such as “no difference” indicate that the statistics being compared were not significantly different.

Lack of comment regarding the difference between any two statistics does not necessarily suggest 

that the difference was tested and found to be not significant. All estimates shown in this report

have a relative standard error less than or equal to 30%. The significance of trends was tested

using weighted least squares regression models of the log of each outcome and Joinpoint software 

(16) to determine whether an apparent change over time was statistically significant, taking into

account the standard error for each data point. Because there were limited data points over the 

period, linear regression (zero joinpoints) was specified for all models.

About the authors

Kristen D. Jackson, LaJeana D. Howie, and Lara J. Akinbami are with the Centers for Disease 

Control and Prevention’s National Center for Health Statistics, Office of Analysis and Epidemiology.
NCHS Data Brief ■ No. 121 ■ May 2013

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References

1. Friedman AH, Morris TL. Allergies and anxiety in children and adolescents: A review of the 

literature. J Clin Psychol Med Settings 13(3):318–31. 2006.

2. Gupta RS, Springston EE, Smith B, Kim JS, Pongracic JA, Wang X, Holl J. Food allergy 

knowledge, attitudes, and beliefs of parents with food-allergic children in the United States. 

Pediatr Allergy Immunol 21(6):927–34. 2010.

3. Vassallo MF, Banerji A, Rudders SA, Clark S, Mullins RJ, Camargo CA Jr. Season of birth 

and food allergy in children. Ann Allergy Asthma Immunol 104(4):307–13. 2010.

4. Akinbami LJ, Moorman JE, Garbe PL, Sondik EJ. Status of childhood asthma in the 

United States, 1980–2007. Pediatrics 123 Suppl 3:S131–45. 2009.

5. Mailhol C, Lauwers-Cances V, Rancé F, Paul C, Giordano-Labadie F. Prevalence and risk 

factors for allergic contact dermatitis to topical treatment in atopic dermatitis: A study in 641 

children. Allergy 64(5):801–6. 2009.

6. Stone KD. Atopic diseases of childhood. Curr Opin Pediatr 14(5):634–46. 2002.

7. Muraro A, Roberts G, Clark A, Eigenmann PA, Halken S, Lack G. The management of 

anaphylaxis in childhood: Position paper of the European Academy of Allergology and Clinical 

Immunology. Allergy 62(8):857–71. 2007.

8. Baiardini I, Braido F, Brandi S, Canonica GW. Allergic diseases and their impact on quality 

of life. Ann Allergy Asthma Immunol 97(4):419–28. 2006.

9. Marklund B, Ahlstedt S, Nordstrom G. Health-related quality of life among adolescents with 

allergy-like conditions—with emphasis on food hypersensitivity. Health Qual Life Outcomes 

2:65. 2004.

10. De Silva IL, Mehr SS, Tey D, Tang ML. Paediatric anaphylaxis: A 5 year retrospective 

review. Allergy 63(8):1071–6. 2008.

11. Lee JK, Vadas P. Anaphylaxis: Mechanisms and management. Clin Exp Allergy 41(7):923–

38. 2011.

12. U.S. Census Bureau. Poverty. 2012. Available from: http://www.census.gov/hhes/www/

poverty/index.html.

13. Schenker N, Raghunathan TE, Chiu PL, et al. Multiple imputation of family income and 

personal earnings in the National Health Interview Survey: Methods and examples. Hyattsville, 

MD: National Center for Health Statistics. 2010.

14. Botman SL, Moore TF, Moriarity CL, Parsons VL. Design and estimation for the National 

Health Interview Survey, 1995–2004. National Center for Health Statistics. Vital Health Stat 

2(130). 2000.

15. SUDAAN, release 9.1 [computer software]. Research Triangle Park, NC: RTI International. 

2004.

16. Joinpoint Regression Program, version 3.4 [computer software]. Bethesda, MD: National 

Institutes of Health, National Cancer Institute. 2010.
NCHS Data Brief ■ No. 121 ■ May 2013

Suggested citation

Jackson KD, Howie LD, Akinbami LJ. 

Trends in allergic conditions among 

children: United States, 1997–2011. 

NCHS data brief, no 121. Hyattsville, MD: 

National Center for Health Statistics. 2013.

Copyright information

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the public domain and may be reproduced 

or copied without permission; citation as to 

source, however, is appreciated.

National Center for Health 

Statistics

Charles J. Rothwell, M.S., Acting Director

Jennifer H. Madans, Ph.D., Associate 

Director for Science

Office of Analysis and Epidemiology

Irma E. Arispe, Ph.D., Director

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